Morning Briefing
Summaries of health policy coverage from major news organizations
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吃瓜不打烊 Original Stories
Hospitals Find Asthma Hot Spots More Profitable To Neglect Than Fix
Months of reporting and rich hospital data portray life in the worst asthma hot spot in one of the worst asthma cities: Baltimore. The medical system knows how to help. But there鈥檚 no money in it.
Attack On Asthma: Scrubbing Homes Of Allergens May Tame Disease And Its Costs
A pilot program to asthma-proof homes in Baltimore shows that even without intensive professional cleaning services, families can learn to substantially reduce home allergens on their own.
Your Plumber Offers A Money-Back Guarantee. Should Your Doctor?
Even though consumers don鈥檛 expect to pay for faulty service or goods, they are often forced to pay for bad health care. But a small number of hospitals and doctors are seeking to change that practice.
Facebook Live: A Status Check On Obamacare Enrollment
In this chat, KHN鈥檚 Julie Appleby offers a progress report on the 2018 sign up season.
Summaries Of The News:
Health Law
Future Of Bipartisan ACA Fix Wobbly Despite Key Role It Played In Securing Tax Bill Votes
Republicans appear to be on the brink of striking down the Affordable Care Act鈥檚 health-insurance requirement, an ardently sought goal of the law鈥檚 opponents. But the fate of a bipartisan bill that centrist Republicans hoped would offset some of the fallout remains uncertain. Some key GOP centrists supported a Senate tax overhaul that repeals the requirement that most people have health insurance, a move experts say will likely drive up premiums, on the condition that it be swiftly accompanied by a bipartisan measure that aims to lower premiums. (Armour and Peterson, 12/5)
聽Speaker聽Paul Ryan's (R-Wis.) office told a meeting of congressional leadership offices on Monday that the Speaker is not part of a deal to get ObamaCare fixes passed before the end of the year, according to a source familiar with the meeting. Senate Majority Leader Mitch McConnell聽(R-Ky.) made a commitment to Sen Susan Collins聽(R-Maine) that he would support passage of two bipartisan ObamaCare bills before the end of the year, a promise that helped win her vote for tax reform. (Sullivan, 12/5)
In other news聽鈥
Kaiser Health News: Facebook Live: A Status Check On Obamacare Enrollment
As of today, Dec. 5, only 10 more shopping days remain for consumers who buy their own Affordable Care Act health insurance on the federal exchange and in most state marketplaces. So how is it going? What are the numbers so far? What are the market trends? And how has the enrollment experience been for consumers? This live chat features KHN senior correspondent Julie Appleby answering these and other questions. (12/5)
Enrollment in the state health insurance exchanges is looking healthier than on the federal platform as local officials deploy targeted advertisements and allow for later deadlines.聽Many states embraced the flexibility that comes with running their own exchange by maintaining a longer enrollment period than the six-week window established this year by the Trump administration. State exchanges have significantly more control over enrollment than states that rely on HealthCare.gov, including the ability to set deadlines. Open enrollment on the federal HealthCare.gov website ends Dec. 15, but states have deadlines as late as Jan. 31. (Clason, 12/6)
Ways And Means Chairman Expects Strong Support For Mandate Repeal From House Republicans
House Ways and Means Committee Chairman聽Kevin Brady聽(R-Texas) told reporters Tuesday that he expects most House Republicans will support repealing ObamaCare's individual mandate in tax legislation, as GOP senators did.聽"We'll be asking our members where do they want us to be on that position. I suspect there will be strong support," he said. (Jagoda, 12/5)
Moderate House Republicans who voted against an overhaul of the health care law earlier this year are keeping quiet on the issue so far. Senate Republicans voted last week to roll back the individual mandate of the 2010 health care law as part of a major tax bill. The provision wasn鈥檛 in a House-passed measure, but it was in an overhaul of the health law that House Republicans passed earlier this year. (McIntire, 12/5)
The Republican Study Committee (RSC), a group of conservative Republicans in the House, is pushing for tax reform to include a repeal of the individual insurance mandate.聽聽"Including language to repeal this harmful policy will return personal decisions about health care choices to patients, fulfilling a key promise we have made to the American people,"聽the RSC wrote in a letter being circulated among members. (Hellmann, 12/5)
Just months after聽Congress failed to repeal Obamacare, local advocates are now scrambling to decipher what the GOP tax overhaul plans could mean for the health care of seniors, children and the disabled.聽The verdict of the (overwhelmingly Democratic) advocates is grim. The Senate tax bill, which dumps the penalty for those who don鈥檛 buy health insurance, will swell the ranks of the uninsured. So much so that more than 1,000 Pennsylvania residents a year could die unnecessarily, they declared Tuesday. Nearly 387,000 tax filers in New Jersey could be in dire straits under the House version, which eliminates the itemized deduction for聽 medical expenses. (Sapatkin, 12/5)
Capitol Watch
For Many It's 'Beyond Belief' That Funding For Wildly Popular CHIP Program Is In Limbo
Laquita Gardner, a sales manager at a furniture rental store here, was happy to get a raise recently except for one problem. It lifted her income just enough to disqualify her and her two young sons from Medicaid, the free health insurance program for the poor. She was relieved to find another option was available for the boys: the Children鈥檚 Health Insurance Program, known as CHIP, that covers nearly nine million children whose parents earn too much for Medicaid, but not enough to afford other coverage. (Goodnough and Pear, 12/5)
A stopgap funding bill revealed last week could further stretch the timeline for renewing funds for the Children鈥檚 Health Insurance Program, but questions remain about how a longer-term renewal will come together.聽The continuing resolution to extend funding for the government and prevent a shutdown that was released last week would make it easier for states to use additional redistributed funding without being subject to a cap. Essentially, the Centers for Medicare and Medicaid Services could distribute leftover federal dollars through the end of the year even to states that already received their maximum share of the redistribution funding under current rules. (Raman, 12/5)
Colorado Gov. John Hickenlooper on Tuesday renewed his call for Congress to reauthorize the Children鈥檚 Health Insurance Program, expressing exasperation and bewilderment that funding for the bipartisan聽children鈥檚 health care program聽had been allowed to expire in the first place.聽鈥淗ow did we get to this point?鈥 Hickenlooper said on a Tuesday afternoon conference call with reporters. 鈥淭o be honest, no one has explained to me why (it hasn鈥檛 been renewed). We know there鈥檚 the votes in the Senate, and we know there鈥檚 the votes in the House. But it is not coming out of committee.鈥 (Eason, 12/5)
Democrats Want To See Funding To Fight Opioid Epidemic In Spending Bill
Top Democrats are pushing for additional federal dollars to combat the opioid epidemic, saying more money is needed to curb the crisis killing thousands of Americans each year.聽Democrats have聽indicated聽that聽additional opioid funding will be聽one of several top priorities聽the party is pushing for in a larger spending deal. But Republicans haven鈥檛 matched their rhetoric, making it unclear if additional dollars will come in a spending package.聽 (Roubein, 12/5)
In other news on the crisis聽鈥
The state medical examiner鈥檚 office is dealing with a heavy workload amid the opioid crisis and staffing shortages. Its case load has nearly doubled in the last two decades due to population growth and the drug crisis. Former chief medical examiner Dr. Andrew Thomas retired this year, and Dr. Jennie Duval took his place. (Ganley and McIntyre, 12/5)
A 28-year-old woman was arrested after she was found in a car unconscious from an overdose with her 19-month-old child inside. (Pinckard, 12/6)
Marketplace
Experts Predict FTC Will Be More Lenient Of CVS-Aetna Deal Than Justice Department
It is uncertain who in the U.S. government will carry out an antitrust review of CVS Health Corp's deal to buy health insurer Aetna Inc, but the drugstore company is likely hoping the potentially more lenient Federal Trade Commission gets the nod, antitrust experts say. The Justice Department's Antitrust Division and Federal Trade Commission share the job of reviewing mergers to make sure they don't hurt consumers, but sometimes it comes down to a coin toss as to who reviews a deal that involves both agencies' areas of expertise. (Bartz, 12/5)
A top House Democrat is calling for a hearing聽to examine the聽merger聽between CVS and Aetna.聽In a聽letter聽to House Energy and Commerce Committee chairman聽Greg Walden聽(R-Ore.), the committee鈥檚 ranking member Frank Pallone Jr. (D-N.J.) asked for a hearing on the merger as soon as possible. (Weixel, 12/5)
And in more news on the $69 billion deal聽鈥
The success of CVS Health Corp.鈥檚 $67.5 billion acquisition of health insurer Aetna Inc. rides on a bet on a complex and untested strategy, and聽some in Wall Street are questioning whether the companies can pull it off.聽CVS plans to build mini health centers in some of its 9,700 stores, turning them into key locations where Aetna members -- and customers of rival insurers -- get low-level care for ailments and chronic diseases. Already, CVS has 1,100 MinuteClinics in its pharmacies, and is testing out hearing and vision offerings in a handful of locations. (Tracer, 12/5)
The architect of the year鈥檚 biggest and arguably most surprising health-care deal is a former pharmacist from rural Pennsylvania who won over Wall Street with a reboot of CVS Health Corp. Larry Merlo, CVS鈥檚 chief executive since 2011, impressed skeptics with his turnaround of Caremark, the pharmacy-benefits manager that CVS bought four years before he took over. (Terlep, 12/5)
Aetna Inc. Chief Executive Mark T. Bertolini is set to pocket roughly half a billion dollars when he leaves his company if it successfully merges with CVS Health Corp. If the $69 billion deal between the pharmacy chain and health insurer goes through, Mr. Bertolini stands to reap a generous exit payment and benefit from a sizable increase in the value of the stock and rights he owns because of the premium CVS is paying for Aetna. His combined payout is expected to be about $500 million, according to people familiar with the matter, a review of Aetna filings, and analysis from compensation-research firm Equilar Inc. (Mattioli, Mathews and Becker, 12/5)
CVS Health Corp.聽could owe聽Aetna Inc.聽$2.1 billion if the drugstore chain鈥檚 acquisition of the health insurer fails, according to a merger agreement filed Tuesday.聽CVS would owe Aetna the funds if the聽deal announced Sunday聽fails for a variety of reasons, including if it can鈥檛 gain approval from antitrust authorities. (Tracer, 12/5)
Women鈥檚 Health
D.C. Latest To Try To Preemptively Protect Women's Health Benefits In Case ACA Is Rolled Back
In anticipation of regulatory rollbacks and the possible repeal of the Affordable Care Act, the D.C. Council voted overwhelmingly Tuesday to block insurance providers in the District from charging additional fees for preventive women鈥檚 health services. The legislation requires insurance providers to offer contraception, breast cancer screening and counseling for sexually transmitted infections without raising co-pays or deductibles. These benefits are required by guidelines released with the Affordable Care Act but are not written into the text of the law and could be erased by federal action. (Chason, 12/5)
The American Civil Liberties Union is pushing back against a claim by the Trump administration that ACLU attorneys acted improperly while helping an immigrant teenager held in federal custody obtain an abortion. The government last month accused the ACLU of misleading the Justice Department during the high-profile case. In papers filed with the Supreme Court, the Justice Department said ACLU attorneys did not alert government lawyers that the teen鈥檚 abortion would take place sooner than they expected. That, the administration says, deprived its lawyers of the chance to ask the Supreme Court to block the procedure, at least temporarily. The government suggested disciplinary action against ACLU attorneys might be appropriate. (Gresko, 12/5)
Breast cancer deaths have declined markedly in the Netherlands since a nationwide screening program began in 1989, but mammograms deserve little 鈥 if any 鈥 of the credit, a new study suggests. In fact, the main impact of inviting Dutch women between the ages of 50 and 74 to get a mammogram every other year has been a steady increase in cases of early-stage breast cancers. More than half of these cancers were harmless and would have gone totally unnoticed if women hadn't had mammograms in the first place, the study authors report. (Kaplan, 12/5)
Public Health
Ban Over Discussing Public Figures' Mental Health 'Scientifically Indefensible,' Experts Argue
A prohibition against psychiatrists discussing the mental health of public figures 鈥 a rule that has become especially controversial, and sometimes flouted, since the inauguration of聽President Trump聽鈥 is 鈥減remised on dubious scientific assumptions,鈥 researchers concluded in an analysis scheduled for publication in a psychology journal.聽The American Psychiatric Association (APA) defends its 鈥淕oldwater rule鈥 by arguing that an in-person psychiatric examination is the gold standard for diagnosing mental illness and psychological traits 鈥 given that there are no blood tests or brain scans for psychiatric disorders. (Begley, 12/6)
Kaiser Health News: Hospitals Find Asthma Hot Spots More Profitable To Neglect Than Fix
Keyonta Parnell has had asthma most of his young life, but it wasn鈥檛 until his family moved to the 140-year-old house here on Lemmon Street two years ago that he became one of the health care system鈥檚 frequent customers. 鈥淚 call 911 so much since I鈥檝e been living here, they know my name,鈥 said the 9-year-old鈥檚 mother, Darlene Summerville, who calls the emergency medical system her 鈥渂est friend.鈥 (Hancock, Bluth and Trielli, 12/6)
Kaiser Health News: Attack On Asthma: Scrubbing Homes Of Allergens May Tame Disease And Its Costs
After years of studying the causes of asthma, a pediatrician-turned-public health sleuth thinks there鈥檚 a way to substantially reduce its impact. But the approach faces a big hurdle: getting someone to pay for it, said Dr. Elizabeth Matsui, a professor at Johns Hopkins medical school in Baltimore.聽Matsui, who suffered from asthma as a child, has spent much of her career studying the link between poor housing and asthma in low-income neighborhoods. (Birch, 12/6)
Air pollution may be harmful to babies even before they are born, a new study has found. Researchers in London calculated mothers鈥 exposure to air pollution and traffic noise in various parts of the city from 2006 to 2010. Then they amassed data on birth weights of 540,365 babies born during those years to women who lived in those areas. (Bakalar, 12/5)
Doctors who are employed under short-term contracts 鈥 called locum tenens (Latin for 鈥渢o hold a place鈥) 鈥 provided a similar level of care as staff doctors, a聽study聽published Tuesday in the Journal of the American Medical Association found. Researchers came to that conclusion after analyzing 1.8 million Medicare patients hospitalized between 2009 and 2014 who were treated by general internists. No significant difference in 30-day mortality rates was seen between patients treated by temp physicians compared to those treated by staff physicians.聽That finding could help dispel the stigma that temp doctors have long faced, researchers said. (Blau, 12/5)
Beautiful. Pure. Natural. Medicine at its pinnacle. Those were the words of Dr. Giuliano Testa this week 鈥 the principal investigator of a clinical trial with ten women underway at Baylor University Medical Center in Dallas. He was talking about the birth of a baby boy to a mother who underwent a uterus transplant last year. It's a first in the U.S., but in Sweden, eight babies have been born to mothers with uterus transplants. (Jochem, 12/5)
Thousands of species have colonized the International Space Station 鈥 and only one of them is Homo sapiens. According to a new study in the journal PeerJ, the interior surfaces of the 17-year-old, 250-mile-high, airtight space station harbor at least 1,000 and perhaps more than 4,000 microbe species 鈥 a finding that is actually 鈥渞eassuring,鈥 according to co-author David Coil. (Kaplan, 12/5)
An experimental Zika vaccine developed by scientists at the National Institute of Allergy and Infectious Diseases is safe and induces an immune response in healthy adults, according to findings from an early stage clinical trial published Monday in The Lancet, a medical journal. The DNA-based experimental vaccine is now in the second phase of clinical trials to determine its safety and effectiveness at preventing infection with Zika virus. (Chang, 12/4)
Influenza activity is rising across the U.S. with the Centers for Disease Control and Prevention reporting recent widespread activity in several states. Serious outcomes of flu infection can result in hospitalization or death. The CDC and the California Department of Public Health are recommending everyone over six months old get vaccinated. (Snibbe and Goertzen, 12/4)
World AIDS Day has been celebrated every Dec. 1 since 1988 as a day of remembrance for those whot have died of and those who are living with the disease. There were many events to mark the day in South Florida, from open-air concerts to free testing. But experts and activists agree that the discussions about treatment and prevention of HIV should be part of an ongoing conversation in the community and not a once-a-year affair. (Garcia, 12/4)
State Watch
Official Struggles To Defend NYC's Lapses On Lead Inspections, Concedes More Could Have Been Done
The embattled chairwoman of the New York City Housing Authority faced withering questioning at the City Council on Tuesday about lapses in lead-paint inspections, and she struggled to explain communication failures that left the public uninformed about the risks they posed. Even as she defended the city鈥檚 response, the chairwoman, Shola Olatoye, conceded that more could have been done over the past year to tell residents what top officials learned in mid-2016: Lead-paint inspections ceased in 2012 and were not restarted for nearly four years. (Goodman, 12/5)
New York City Housing Authority Chairwoman Shola Olatoye told the City Council that she regretted submitting documentation to federal officials showing the agency was in compliance for lead paint when it hadn鈥檛 conducted the required inspections in four years. 鈥淪igning the forms at that time was a mistake,鈥 she said during nearly four hours of testimony. She said she thought at the time that an informal notice to federal officials was sufficient. (Gay, 12/5)
State Highlights: Health Policies Move Into Focus In Md., Iowa Gubernatorial Races; Fla. Cancer Center Uses Math To Pursue Treatments, Cure
Democratic gubernatorial candidate Ben Jealous released a plan Wednesday calling on Maryland to take the plunge and create a universal health care system without waiting for the the federal government to take the lead.聽The release of Jealous鈥 outline of a statewide 鈥淢edicare for all鈥 plan comes as he is planning a Wednesday night rally at the College of Notre Dame with 2016 presidential candidate Sen. Bernie Sanders, a supporter of single-payer health care who has endorsed Jealous鈥 candidacy. (Dresser, 12/6)
A dozen candidates for governor gathered Tuesday night to lay out their plans for improved access, funding and treatment for mental health services across the state.聽At a public panel hosted by The Des Moines Register, the candidates voiced near-universal criticism of Iowa's privatized Medicaid system, which聽has faced a tumultuous couple of months following the departure of one of the private companies hired to provide services. (Pfannenstiel, 12/5)
On any given day, the lobby at Moffitt Cancer Center is buzzing with patients and their families. A few are waiting to check in for another round of chemotherapy. Others are hopeful for more good news about their remission. Some look more tired than others. Above them, on an upper floor, a group of staffers is working to find new ways to fight or even cure cancer, but they aren鈥檛 doctors or nurses, and their office looks nothing like the rest of the hospital. (Griffin, 12/5)
The first scheme that Constantino Perales ran involved some simple math. He'd provide a drug dealer with hundreds of oxycodone and Xanax pills and the man would pay the doctor $15 to $20 for every tablet he sold, according to federal prosecutors. The second scheme was even simpler, if baser. Perales would write prescriptions for the drugs; in return, his drug-addicted patients would have sex with him, the prosecutors say. (Wootson, 12/5)
In a victory for R.J. Reynolds Tobacco Company, the Florida Supreme Court on Monday declined to take up a case that initially involved a more than $23 billion verdict against the cigarette maker. The estate of Michael Johnson Sr., a longtime smoker who died at age 36, asked the Supreme Court to take up the case after the 1st District Court of Appeal in February ordered a new trial. (12/4)
Brooklyn prosecutors said Tuesday that they charged 20 people and 14 corporations in a $146 million fraud scheme, calling it the biggest health-care case in their office鈥檚 history. The defendants paid patients to come to clinics, where they received unnecessary tests that were subsequently billed to Medicare and Medicaid, prosecutors said. The defendants then spent the proceeds on real estate, luxury shopping sprees and lavish vacations, according to an indictment. (Ramey, 12/5)
A federal judge heard wildly conflicting stories Tuesday about a prominent Florida eye doctor convicted in a $100 million Medicare fraud scheme. Some former patients said Dr. Salomon Melgen restored their sight for free, while others described painful and unnecessary treatments that left them blind. Melgen, 63, is facing a possible life sentence after being found guilty of 67 counts, including health care fraud, submitting false claims and falsifying records in patients鈥 files. Evidence presented during his trial earlier this year showed he subjected patients to unnecessary procedures, including sticking needles in their eyes and burning their retinas with lasers. (Spencer, 12/5)
San Joaquin County鈥檚 chief medical examiner, known nationally as the doctor depicted in the movie 鈥淐oncussion鈥 about brain injuries among football players, resigned Tuesday over what he said was interference by the sheriff that has become so invasive that it borders on the unlicensed practice of medicine. Dr. Bennet Omalu accused Sheriff-Coroner Steve Moore of routinely interfering with death investigations to protect law enforcement officers. (Thompson, 12/5)
An Oklahoma City police officer was charged Tuesday with second-degree murder in the fatal shooting of a suicidal man who had doused himself in lighter fluid and was trying to set himself on fire. District Attorney David Prater filed the charge against Sgt. Keith Sweeney and listed an alternative charge of first-degree manslaughter in the Nov. 15 killing of 29-year-old Dustin Pigeon. An affidavit by a police investigator concluded that Pigeon was unarmed and didn鈥檛 pose a threat to responding officers when Sweeney shot him. (Miller and Juozapavicius, 12/5)
One of the state's largest hospital systems is suing its former chief executive alleging, among other things, that she violated federal anti-kickback laws. The North Broward Hospital District on Monday filed a countersuit against its former CEO, Pauline Grant, in Broward County circuit court alleging that she violated the hospital's code of conduct by serving as secretary of the board of directors of John Knox Village, a long-term care provider that had contracts with the hospital system. (12/5)
Shay Jackson starts her day at 4 a.m, seeking the early morning 鈥渕e time鈥 with prayer and Bible study before chaos ensues. Before heading to her state job, there鈥檚 breakfast to be made for her children, ages 7 and 3. Her grandmother, 79-year-old Audrey Strong, is undergoing treatment for lung cancer and needs assistance getting dressed. Jackson, 32, tag-teams the responsibilities with her husband, Chris Jackson, who gets the children to school in the morning and works afternoons. (Sullivan, 12/3)
As state and local officials continue searching for ways to reduce Ohio鈥檚 stubbornly high infant-mortality rate, a new report released Wednesday urges them to look beyond medical care. Improving social and economic conditions such as housing, transportation, education and employment opportunities could help Ohio make faster progress in reducing the number of babies dying before their first birthday. (Candisky, 12/5)
At least two buildings on the campus of Vista Del Mar Hospital burned down as the Thomas fire ravaged the canyons above Ventura. The hospital treats adolescents and adults with mental health issues, and among its specialties is treatment for post-traumatic stress disorder. (Hamilton, 12/5)
A former California state lawmaker was charged with providing a gun to his wife so she could kill herself last year. Former Assemblyman Steve Clute was charged Thursday in Riverside County Superior Court with a felony count of aiding the suicide of his wife of about 40 years. Pamela Clute, 66, a well-liked math professor and administrator at the University of California, Riverside, was found dead in the couple鈥檚 Palm Desert home in August 2016. About 500 people attended a campus memorial service for her. (12/5)
Los Angeles officials have debated for decades how best to provide for one of the most basic needs of homeless people. For those camped in the 50-block skid row district, the streets have been an open-air restroom 鈥 with only nine toilets available overnight in recent months to as many as 1,800 people camped on sidewalks. (Holland, 12/5)
The Elliott who recently greeted visitors with a big grin and a T-shirt declaring him a 鈥淧erfect Gentleman,鈥 and proudly showed off a paper airplane that came close to flying, is far different from the Elliott who would have come to the door less than a year ago. That Elliott 鈥 the one still reeling from the years of abuse against himself, his siblings and his mother, the one who had yet to get behavioral therapy for his autism 鈥 would have violently rejected new people, said his mother, Hasina Brinson. (Mazzei, 12/5)
Adventist Health System, the parent company of Florida Hospital, announced Tuesday that it plans to buy Bayfront Health Dade City hospital and its related outpatient services. The deal is expected to close in the first quarter of 2018, which will make it the 11th hospital in the chain to join the West Florida Division of Adventist Health System, according to a press release. Terms of the deal were not disclosed. The transaction is subject to customary regulatory approvals. (Griffin, 12/5)
The Ohio Department of Commerce came under fire from state officials Tuesday for hiring a medical marijuana program consultant who had a felony drug conviction on his criminal record. The felony conviction would have disqualified the consultant from being awarded the medical marijuana cultivation licenses he was helping to score. (Borchardt, 12/5)
Prescription Drug Watch
CVS-Aetna Is Talk Of Town, But UnitedHealth Has Already Been There, Done That. (Sort Of)
As the specter of Amazon.com Inc. looms over the health-care industry, it鈥檚 easy to see the tech giant鈥檚 threat as a major factor behind the megadeal between CVS Health Corp. and Aetna Inc. Yet the $67.5 billion deal will build a company to match up against a rival that already has businesses spread deep across the sector: UnitedHealth Group Inc. (Tracer, 12/4)
Scrutiny of a key profit source for the drug industry is increasing. That means it is getting harder for investors to forecast industry growth. The Department of Health and Human Services鈥 Office of Inspector General last week revoked a key favorable advisory opinion for Caring Voice Coalition, one of the largest U.S. charities that helps patients afford insurance copayments for their medicine. The OIG said in a letter, first reported by Bloomberg News, that the charity had provided undue influence to its donors over how the charity was run. The charity said that the loss of the OIG stamp of approval would likely cause it to cease operating. (Grant, 12/6)
Over the past two years, the National Institutes of Health has been pressed by various lawmakers and advocacy groups to help alleviate the high cost of medicines. Citing federal law, they have urged the agency to take action when a prescription drug 鈥 one that was discovered with taxpayer dollars and later licensed to a drug maker 鈥 was not considered affordable. So far, though, the NIH has demurred.聽On Thursday, NIH Director Francis Collins explained why. In testimony before a House Energy聽 and Commerce subcommittee, he maintained federal law does not provide any 鈥渓evers to pull.鈥 (Silverman, 12/1)
U.S. FDA Commissioner Dr. Scott Gottlieb relayed a new guidance Tuesday that may shed some light on the path generic-drug manufacturers can take to get their products to market. The Food and Drug Administration aims to make it easier for generic-pharmaceutical developers to plan how they can copy complex drugs, which should ultimately lower pharmaceutical prices when more of the cheaper drugs enter the market. Certain drugs have been difficult to replicate and gain regulatory approval for, particularly drug-device combinations like EpiPen, because there has been minimal guidance from the FDA on how to adequately do so. (Kacik, 11/29)
U.S. patents on key components for some important HIV therapies are poised to expire starting in December and聽Laurus Labs Ltd.聽-- the Hyderabad, India-based company which owns the facility -- is gearing up to cash in.聽Laurus is one of the world鈥檚 biggest suppliers of ingredients used in anti-retrovirals,聽thanks to novel chemistry that delivers cheaper production costs than anyone else. Now, its chief executive officer,聽Satyanarayana Chava, wants to use the same strategy selling his own finished drugs in the U.S. and Europe. He predicts some generics that Laurus produces will eventually sell for 90 percent less than branded HIV drugs in the U.S., slashing expenditures for a disease that鈥檚 among the costliest for many insurers. (Altstedter, 12/4)
Avanir Pharmaceuticals is cutting 73 employees in 鈥渟ales-related positions,鈥 or roughly 11 percent of its workforce, according to a recent filing with California state officials. A spokesman confirmed the move and described it as an effort to 鈥渟treamline our current approach to sales and better position Avanir to pursue its long-term mission.鈥 The layoffs occur as that mission is coming under scrutiny. (Silverman, 12/5)
Inspired by a ProPublica story in April that described how nursing homes and their pharmacies nationwide throw away hundreds of tons of valuable medicines 鈥 and how one Iowa nonprofit successfully recycles them 鈥 two states are working to create similar programs. (Allen, 12/1)
In a bid to blunt criticism of drug pricing, Alnylam Pharmaceuticals (ALNY) is going back to the future. The drug maker plans to limit any future price hikes on a widely anticipated rare-disease drug to the inflation rate, a step that no drug maker has voluntarily embraced in more than two decades. 鈥淎s we transition from being an innovative R&D-stage company to a commercial-stage company, we are launching a set of patient access principles,鈥 Alnylam chief executive John Maraganore said. 鈥淲e plan to grow through innovation, not through price increases. We鈥檒l raise prices to match the Consumer Price Index, and that鈥檚 it. And otherwise, we鈥檒l grow, as a company, through innovations.鈥 (Silverman, 11/30)
Biogen Inc. has named a pharmaceuticals industry information-technology veteran as its new chief information officer, as the biotech firm seeks innovative IT tools to help develop treatments for Alzheimer鈥檚, dementia and other neurological diseases, the company said. Mark Hernon joins the Cambridge, Mass., firm from Takeda Pharmaceuticals Co., Japan鈥檚 largest drugmaker by sales, where he served as a regional CIO for the Americas, as well as global head of R&D and a vice president of operations. He was previously CIO and vice president of operations at Millennial Pharmaceuticals. (Loten, 12/5)
For some opioid makers, the financial outlook is painful. Between falling prices for many of the medicines and fast-growing litigation, a few of these companies have only modest flexibility to cope with these mounting risks, according to a new analysis by Moody鈥檚 Investor Service. And the drug maker most likely to be impacted is Endo International (ENDP). (Silverman, 12/1)
A New York hedge fund that earlier this year flipped the board of Depomed Inc. and installed a new CEO to boost the company's value said Monday that it will cut 40 percent of its staff and move the drug company's headquarters out of California. The move is necessary, Depomed said in a Securities and Exchange Commission filing, because it is turning over sales of its best-selling pain drug, Nucynta, to Collegium Pharmaceutical Inc. and won't need as large of a workforce or as much space at its Newark headquarters. (Leuty, 12/4)
Medicaid patients with rheumatic diseases are not only battling their chronic conditions, but also their insurance providers in a fight for medications. (Christ, 12/4)
Perspectives: It's Past Time For The Government To Intervene Over High Drug Prices
The tales of woe, some seemingly catastrophic, are too many and too common. A patient is diagnosed with a rare illness for which there is a miracle or near-miracle drug, but the cost of that drug is either prohibitive, period, or will in a very short time break the patient and his family. It is a state in which patients in other countries, where drug prices are notably cheaper than they are in the United States, do not find themselves. But drug-makers offer a weary excuse: They have to pay for research and development and should be allowed to recoup their costs and make a profit. (12/5)
The ongoing furor over the price of prescription pharmaceuticals has become so intense that even an august, establishment group like the National Academy of Sciences, Engineering, and Medicine (NAS) cannot help but weigh in. Its report, 鈥淢aking Medicines Affordable: A National Imperative,鈥 released Thursday, is encouraging, as it is from an eminent group long on scientists and short on politicos, hinting at a rare, nonpartisan objectivity befitting the Academies. (John Osborn and David Beier, 11/30)
Joe Biden wants to be president, the champion of working families. But there is another side to the former vice president: protector of big pharmaceutical companies, indifferent to the harsh consequences of high drug prices. If Biden wants to pursue a future in politics, he ought to consider a reboot on drug pricing issues. (James Love, 11/30)
US Food and Drug Administration (FDA) approval of a new drug typically coincides with a period of patent protection, during which the manufacturer will often apply for additional indications to expand the market for the product. ... This pattern of additional testing and approvals is common for more expensive on-patent drugs, but new indications are rarely sought for less-expensive generic drugs, for which it is more difficult to profit from the research. This creates a policy conundrum: follow-on innovation for low-cost generic products offers a rare opportunity to simultaneously improve health outcomes and likely reduce health care expenditures, but how could such research be encouraged? (Rachel E. Sachs, Paul B. Ginsburg and Dana P. Goldman, 12/4)
Allergan PLC's golden goose might be getting tired.Botox is Allergan's best-selling product and an essential growth driver for the company. It is notoriously tough to replicate. But at least one competitor is giving it a real go: Revance Therapeutics Inc., a Newark, California-based biotech, released promising trial data Tuesday on an injection that may last longer than Botox. (Max Nisen, 12/5)
Editorials And Opinions
Viewpoints: Argument For Individual Mandate Repeal; CHIP Stalemate Highlights Senate Dysfunction
They may not have succeeded in repealing and replacing Obamacare, but Republicans are close to undoing the law鈥檚 least popular feature. The Senate has passed a tax bill to abolish Obamacare鈥檚 fines on people who go without health insurance -- the so-called individual mandate. House Republicans are very likely to agree on that provision. (Ramesh Ponnuru, 12/6)
Two decades ago, lawmakers created a joint state-federal health insurance program designed to assist low- to moderate-income children and pregnant women who are not eligible for Medicaid. Within three years, every state opted into the program. Today, the Children鈥檚 Health Insurance Program, commonly known as CHIP, provides access to comprehensive, affordable coverage to more than 8 million children nationwide. ... For reasons known only to a fractured U.S. Senate more interested in ramming through an ill-conceived and widely denounced major overhaul of the federal tax code, CHIP has languished for months. It now sits at risk of running out of money. (12/6)
Far be it from me to suggest that Kellyanne Conway could not possibly be the opioid czar. When I was named Ebola response coordinator in October 2014, the outrage over a 鈥減olitical operative鈥 taking on such an assignment was widespread. I like to think I had more qualifications than Conway: three stints in two White Houses, chief of staff at a Cabinet agency and leadership of the team implementing a $787 billion federal program 鈥 but crucially, like her, I lacked domain expertise in epidemic response. Thus, just as I hoped at that time to be judged by my performance on the job and not my r茅sum茅, I take a similar view of Conway鈥檚 appointment. (Ronald A. Klain, 12/5)
What if your profession has never required much computer literacy -- and then all of a sudden it does. Should you be fired? Should your license be yanked? That鈥檚 the question raised by the bizarre case of Anna Konopka, a physician who claims that New Hampshire has barred her from the practice of medicine because she does not know how to use the Internet. Konopka, 84, received the bulk of her medical training overseas. She voluntarily surrendered her license this fall after allegations that she was not participating in New Hampshire鈥檚 new mandatory system for reporting opioid prescriptions. Why not? Because to do so she would have to go online -- something for which she lacks the requisite skill. (Stephen L. Carter, 12/5)
I have been a wheelchair user since early childhood, when I sustained a spinal cord injury in a farming accident. I am now a practicing physician in the field of rehabilitation and sports medicine. In my busy outpatient clinical practice, I witness the spectrum of patients鈥 reactions when they find out that their doctor is, herself, disabled. Typically those first few seconds after entering an exam room 鈥 before the patient鈥檚 guard goes up 鈥 are the most informative. (Cheri A. Blauwet, 12/6)
This summer, the Missouri Legislature decided that landlords and employers should have a louder voice in women鈥檚 reproductive health choices than the women themselves. On July 25, lawmakers passed Senate Bill 5, an anti-abortion bill that enforces highly restrictive and time-consuming regulations on abortion providers that would prevent women from receiving the services they need in a timely manner. (Namita Kansal, 12/5)
Big tobacco is spending millions of dollars to inform Americans of the truth about their products 鈥 truth that those same companies spent decades denying and trying to litigate to death. News media companies spent millions defending themselves against Big Tobacco in court simply for having reported the very truths that Big Tobacco now must spend millions to advertise themselves. (12/5)
In October, Philadelphia won the distinction of being the first major city in the United States to introduce a tax on sugary carbonated drinks. Proponents of the tax contend that it鈥檚 a wonderful way to bridle Philadelphians鈥 sugar cravings while simultaneously bolstering the city鈥檚 revenues. Across the Atlantic in Lithuania, legislators took the same approach with regard to alcohol and adopted legislation substantially increasing taxes on beer and wine. The intentions held by legislators who champion these sorts of taxes, often termed 鈥渟in taxes,鈥 are generally admirable. However, the technical merits of taxes like these are lacking and, worse, they鈥檙e often liable for inadvertent harm. (Michael Shindler, 12/6)
There is a crisis brewing in China. I鈥檓 not talking about anything military or political. The newly constitutionalized Xi Jinping Thought, a set of principles meant to guide Chinese economic, political, and military expansion in the next two decades, has been silent on the issue of national health care, which may threaten the long-term stability of China. The first highly public sign of trouble came in a 2013 report published in the Journal of the American Medical Association by Chinese scientists from Peking University and the Chinese Center for Disease Control and Prevention. Their survey of more than 170,000 Chinese adults showed that 10.9 percent have diabetes, higher than the U.S. rate of 9.4 percent. (Justin Fendos, 12/5)
Sticking to a medication regimen is as important for people with mental illness as it is for those with physical illness. But what makes Abilify MyCite, a high-tech version of aripiprazole, problematic is that it could easily be incorporated into forced treatment, which ignores the values and preferences of people with mental illness. Involuntary treatment has a long and painful history in mental health. Without their consent, people with mental illness can be committed to inpatient or outpatient treatment, and sometimes forced to take medications. Only in the 1970s did the U.S. Supreme Court first address the lack of rights for people hospitalized against their will. (Tia P. Powell, 12/5)